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Parish Registration

- Parish Registration

Hello and welcome to Mary, Mother of God! We are so thankful that you have considered becoming a member of our parish family. We would love to assist you and your family in any way possible. In order to help, we would like to hear from you! Please fill out our basic parishioner information (which can be filled out below).

For our non-Catholic members, we offer RCIA and Faith Formation classes. The RCIA program is designed for non-Catholic adults who are interested in joining the Catholic Church while Faith Formation is an education program offered to children.

We want you to feel at home within our church community. If you have any questions, please contact the parish office. Thank you and welcome!
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- Family Last Name: REQUIRED Please fill out this field. Please enter valid data.
- Address to include city, state and zip code: REQUIRED Please fill out this field. Please enter valid data.
- Primary Phone Number: REQUIRED Please fill out this field. Please enter a phone number.
- Please list what type of Primary Phone REQUIRED Home Cell Work Please fill out this field.
- Would you like offertory envelopes? Yes No
- Would you be interested in online giving? Yes No
- Are you or any of your family members familiar with Protecting God's Children? Yes No
- Head of Household
- Full Name: REQUIRED Please fill out this field. Please enter valid data.
- Title:
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Gender REQUIRED Male Female Please fill out this field.
- Religion: REQUIRED Please fill out this field. Please enter valid data.
- Marital Status REQUIRED Single Catholic Marriage Non-Catholic Marriage Widow/Widower Separated Divorced Please fill out this field.
- Additional Phone Numbers:
- Please list what type of Phone listed above REQUIRED Home Cell Work Please fill out this field.
- Email Please enter an email address.
- Occupation: Please enter valid data.
- Sacraments Received: (Please check all that apply) REQUIRED Baptism First Communion Confirmation Matrimony Please fill out this field.
- For the Sacraments checked, please list date received and location:
- Talents, Skills, or Interests that you would like to share with your parish family:
- Spouse
- Full Name: REQUIRED Please fill out this field. Please enter valid data.
- Title:
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Gender REQUIRED Male Female Please fill out this field.
- Religion: REQUIRED Please fill out this field. Please enter valid data.
- Marital Status REQUIRED Single Catholic Marriage Non-Catholic Marriage Widow/Widower Separated Divorced Please fill out this field.
- Maiden Name Please enter valid data.
- Additional Phone Numbers:
- Please list what type of Phone listed above REQUIRED Home Cell Work Please fill out this field.
- Email Please enter an email address.
- Occupation: Please enter valid data.
- Sacraments Received: (Please check all that apply) REQUIRED Baptism First Communion Confirmation Matrimony Please fill out this field.
- For the Sacraments checked, please list date received and location:
- Talents, Skills, or Interests that you would like to share with your parish family:
- Children (Age 17 and younger residing at this address)
  Only complete the number of sections for the number of kids residing at the same address.
- Children REQUIRED Please fill out this field.
  
  Child 1
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Name of School Child is attending Please enter valid data.
  
  Grade
  
  Religion Please enter valid data.
  
  Sacraments Received: (Please check all that apply) Baptism First Communion Confirmation
  
  Child 2
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Name of School Child is attending Please enter valid data.
  
  Grade
  
  Religion Please enter valid data.
  
  Sacraments Received: (Please check all that apply) Baptism First Communion Confirmation
  
  Child 3
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Name of School Child is attending Please enter valid data.
  
  Grade
  
  Religion Please enter valid data.
  
  Sacraments Received: (Please check all that apply) Baptism First Communion Confirmation
  
  Child 4
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Name of School Child is attending Please enter valid data.
  
  Grade
  
  Religion Please enter valid data.
  
  Sacraments Received: (Please check all that apply) Baptism First Communion Confirmation
  
  Child 5
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Name of School Child is attending Please enter valid data.
  
  Grade
  
  Religion Please enter valid data.
  
  Sacraments Received: (Please check all that apply) Baptism First Communion Confirmation
  
  Child 6
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Name of School Child is attending Please enter valid data.
  
  Grade
  
  Religion Please enter valid data.
  
  Sacraments Received: (Please check all that apply) Baptism First Communion Confirmation
- Additional Adults (Age 18 and older residing at this address)
  Only complete the number of sections for the number of other unlisted members residing at the same address.
- Adults REQUIRED Please fill out this field.
  
  Adults 1
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  School/Employment:
  
  Religion: Please enter valid data.
  
  Sacraments Received: (Check all that apply) REQUIRED Baptism First Communion Confirmation Matrimony Please fill out this field.
  
  For the Sacraments checked, please list date received and location:
  
  Adults 2
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  School/Employment:
  
  Religion: Please enter valid data.
  
  Sacraments Received: (Check all that apply) REQUIRED Baptism First Communion Confirmation Matrimony Please fill out this field.
  
  For the Sacraments checked, please list date received and location:
  
  Adults 3
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  School/Employment:
  
  Religion: Please enter valid data.
  
  Sacraments Received: (Check all that apply) REQUIRED Baptism First Communion Confirmation Matrimony Please fill out this field.
  
  For the Sacraments checked, please list date received and location:
  
  Adults 4
  
  Full Name: REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth: REQUIRED Please fill out this field. Please enter a date.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  School/Employment:
  
  Religion: Please enter valid data.
  
  Sacraments Received: (Check all that apply) REQUIRED Baptism First Communion Confirmation Matrimony Please fill out this field.
  
  For the Sacraments checked, please list date received and location:
- Emergency Contact: REQUIRED Please fill out this field. Please enter valid data.
- Additional Comments, Questions, or Concerns:
- Comments, Questions, or Concerns:
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Parish Registration

Head of Household

Children (Age 17 and younger residing at this address)

Additional Adults (Age 18 and older residing at this address)

Additional Comments, Questions, or Concerns: